Asthma Healing

Bronchodilator asthma inhalers . Bronchodilator asthma inhalers are either short-acting or long-acting. They are used to ease asthma symptoms such as wheezing, shortness of breath, and coughing.  Inhaled bronchodilators dilate or widen the airways, which helps relieve asthma symptoms much faster than oral medications. Bronchodilator drugs used in asthma inhalers include:

• Short-acting beta-agonists including albuterol (Proventil HFA, Ventolin HFA, AccuNeb), Alupent, Maxair, Xopenex
• Long-acting beta-agonists, including Serevent (salmeterol) and Foradil (formoterol). The combination inhalers currently available in the United States are Advair and Symbicort.
• Combivent and DuoNeb inhalers contain both albuterol and ipratropium (an anticholinergic bronchodilator). This combination of albuterol and ipratropium may also be given using a nebulizer.

How can I be sure there's medication in my asthma inhaler?

Many new inhalers include a counter.  For the others, knowing how much medication is available in an asthma inhaler is a problem. Many people with asthma tell of using their inhalers until they can no longer hear a "puff" sound when they try to spray it. The problem is that most asthma canisters generate a puff sound long after the asthma medication is gone. You may be using the asthma inhaler properly and hearing the puff sound when you spray it, yet the asthma inhaler canister may be completely empty. This is a serious problem when you depend on the inhaled medication to relieve asthma symptoms.

The best way to know how many doses remain in an asthma inhaler without a counter is to mark the number of doses used on the inhaler and then toss the inhaler after you've used this number of puffs. You can find the total number of doses on the asthma inhaler box or canister.  Mark the date on your calendar when you expect to use all of the available puffs in the new asthma inhaler and obtain a new asthma inhaler before this date. Keep one or two extra quick-relief inhalers at home.  Carefully review the instructions that came with the inhaler (or locate them online).  Some inhalers must be shaken before each use; others must be primed if not used for several days.

When is a spacer used with an asthma inhaler?

A spacer is a tube that attaches to the asthma inhaler and holds the medication until you can breathe it in. This makes using the asthma inhaler easier and helps to deposit the medication into the lungs more efficiently. Not all inhalers should be used with a spacer, so discuss this with your pharmacist. There are times that an MDI or asthma inhaler may be used without a spacer. Your doctor will decide which method of using an asthma inhaler is best for you.

Spacers with masks are available for use by small children or anyone else that may not be able to breathe in correctly through a standard spacer connect to an asthma inhaler.

How do I use an MDI asthma inhaler correctly?

To use an asthma inhaler (MDI) with a spacer:

1. Remove the caps from the asthma inhaler and spacer device. Shake the asthma inhaler well to make sure the medication is available.
2. Insert the asthma inhaler into the open end of the spacer, which is opposite the mouthpiece.
3. Place the mouthpiece of the spacer between your teeth and seal your lips tightly around it.
4. Breathe out completely.
5. Press the canister of the asthma inhaler once to release the medicine. The medicine will be trapped in the spacer.
6. Breathe in slowly and completely through your mouth. With some spacers, you will hear a horn-like sound if you are breathing too quickly. This means you need to slow down on your next breath.
7. Hold your breath for at least 10 seconds to allow the medication to deposit in your lungs.
8. Wait for about one minute and then repeat Steps 1-7 for every puff of medication ordered.
9. Replace the caps on your asthma inhaler and spacer when finished.
10. If you are using an MDI that contains a steroid, gargle and rinse your mouth with water or mouthwash after each use.

To use an asthma inhaler (MDI) without a spacer:

1. Remove the cap from the asthma inhaler and shake it well.
2. Hold the asthma inhaler by placing your index finger on top of the metal canister and thumb on the bottom of the plastic mouthpiece.
3. Tilt your head back slightly and breathe out.
4. Open your mouth wide, and place the asthma inhaler about 2 inches in front of your mouth.
5. Breathe in and out one time.
6. As you begin to inhale on your next breath, press the metal canister down. Breathe in slowly and as deeply as you can. You should breathe in for about three to five seconds
7. Hold your breath for at least 10 seconds to allow the medication to deposit in your lungs.
8. After waiting at least one minute, repeat Steps 1-7 for each puff of medication ordered.
9. Replace the cap on your asthma inhaler when you are finished. If you are using an asthma inhaler that contains a steroid, gargle and rinse your mouth with water or mouthwash after each use.

To use an asthma inhaler (MDI) with a mask spacer:

Mask spacers are used for small children who are unable to properly use a spacer with a mouthpiece. These are usually used for children from infancy through about age 5. Occasionally, due to other medical conditions, adults and older children may not be able to properly use the standard spacer. Large masks are available for these patients.

1. Remove the cap from the asthma inhaler and shake it well.
2. Place the asthma inhaler in the soft ring at the end of the spacer opposite the mask.
3. Place the mask securely over your child's nose and mouth, making sure there is a good seal.
4. Spray one puff of medication into the spacer.
5. Hold the mask firmly in place while your child takes six breaths.
6. Wait about one minute.
7. Repeat the above steps for each puff of medication ordered.
8. When completed, remove asthma inhaler from spacer.
9. If using a corticosteroid asthma inhaler, wash the face with mild soap and water after use to remove medication. If possible, also rinse your child's mouth with water.